The most prevalent type of cutaneous T-cell lymphoma is mycosis fungoides. Due to its excellent efficacy, phototherapy (narrowband ultraviolet B and psoralen and ultraviolet A) is one of the most often used treatments for early-stage mycosis fungoides. However, disease recurrence is common upon treatment discontinuation

The purpose of a recent study published in the Indian Journal of Dermatology, Venereology and Leprology was to establish the efficacy of phototherapy in the treatment of early-stage mycosis fungoides, as well as to identify predictive factors for complete remission, disease recurrence and the utility of maintenance therapy. 

This was a 17-year retrospective cohort study including 61 patients with early-stage mycosis fungoides (IA - IB). All patients were treated with narrowband ultraviolet B or psoralen and ultraviolet A as first-line therapy between 2002 and 2018. 

The results showed that 57 (93.5%) of the patients obtained full remission. The median time to remission was 7.80±0.27 months. However, the types of phototherapy (narrowband ultraviolet B or psoralen and ultraviolet A), age and gender had no effect on time to remission. Whereas, the presence of poikiloderma and a higher disease stage resulted in a longer time to remission. The total incidence of relapse was 50.8 %; the median time to relapse was 24.78±5.48 months. A treatment duration of more than six months in patients receiving phototherapy during the maintenance period was associated with a considerably longer relapse-free interval. The appearance of altered skin color, thinning of the skin, visible blood vessels on the skin and a more advanced illness stage were linked to a longer time to disease resolution. Maintaining remission with phototherapy for at least six months was favorable. 

It was inferred that phototherapy is an excellent therapeutic option for treating mycosis fungoides in its early stages.

Source: Indian Journal of Dermatology, Venereologyand Leprology. Sep-Oct 2021;87(5):645-650. doi: 10.25259/IJDVL_555_19.